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We have to reduce major risk factors like smoking, and provide good health services that help both with prevention through high-quality GP services and with treatment”

End QuoteProf Majid Ezzati,Imperial College London

And they warn that the forthcoming devolution of public health responsibilities to local authorities might also put some communities at risk.

Dr Perviz Asaria, who worked on the study, said: "If people's jobs are less stable, they may be forced to change their diet, or drink and smoke more.

"So we need to be concerned about these issues if we are going to carry on bringing death rates down."

She added: "As public health gets taken up by local authorities, there's a danger that health budgets will have to compete with other services such as schools.

"It's essential that cardiovascular screening and prevention programmes don't get cut as a result."

Prof Majid Ezzati, who also worked on the research, said a major aim of the study was to find out what was being done to help people in different places and what could be done differently.

He said: "We know how to reduce cardiovascular mortality: we have to reduce major risk factors like smoking, and provide good health services that help both with prevention through high-quality GP services and with treatment.

"We need to focus on putting these into practice in places that are behind."

Mubeen Bhutta, policy manager at the British Heart Foundation, said: "The overall decline in heart disease death rates should be something to celebrate but, worryingly, that improvement has not benefited everyone equally.

"If we're going to make a proper job of tackling England's biggest killer, eradicating inequalities must be at the heart of the government's new cardiovascular disease strategy."

She added: "The communities that need help the most must not be forgotten, and targeted interventions in the poorest neighbourhoods will help address a problem which has dogged this country for decades."

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